Hello Doctor
I've been dealing with acne for the past three years, and it's becoming quite frustrating. I've tried Doxy twice, but unfortunately, it hasn't made much of a difference. What's odd is that I never had acne as a teenager; it only started when I hit my thirties. My dermatologist recommended trying Accutane, but then I sought advice from a gynecologist who suggested spironolactone, suspecting it might be linked to PCOS, despite not experiencing any other symptoms. I'm hesitant about potential side effects and want a treatment that's both effective and safe. What steps would you recommend in this situation to address the acne without causing any unwanted side effects?
Hello
Thank you for reaching out to Dr. Galen. Please find the below response to your query.
1. Accutane (Isotretinoin):
Accutane, or isotretinoin, is a potent medication often recommended for severe or persistent acne. It effectively reduces oil production, prevents clogged pores, and decreases inflammation. However, due to potential side effects, such as dry skin, lips, and eyes, as well as mood changes and birth defects if taken during pregnancy, Accutane requires careful monitoring. To mitigate the risk of birth defects, strict adherence to effective contraception during treatment and for at least six months afterward is crucial. Given the severity and persistence of acne, Accutane may offer the most effective solution, but its use necessitates close supervision and adherence to contraceptive measures.
2. Spironolactone:
Spironolactone is commonly prescribed for acne, especially when hormonal imbalances like those associated with PCOS are suspected. It works by blocking androgen receptors, thereby reducing oil production and acne formation. Spironolactone is generally well-tolerated, but side effects such as increased urination, breast tenderness, and irregular menstrual cycles may occur. Although effective for many individuals, significant improvement in acne may take several months to manifest. Spironolactone could be a suitable option, particularly if hormonal factors like PCOS contribute to acne. However, it's crucial to discuss potential side effects and closely monitor your response with a healthcare provider.
Thanks
